Length Of Training Research Articles

Perception of congenital cardiac surgery as a career choice among cardiothoracic surgery trainees in the United Kingdom.

Our goal was to evaluate interest among trainees in pursuing congenital cardiac surgery (CCS) as a sub-specialty career and probe for reasons in decline in interest. An anonymized, voluntary survey of cardiothoracic surgical trainees across the United Kingdom and Ireland was conducted from October 2020 to December 2020. The questionnaire included demographics, congenital experience and career intentions. A total of 43 respondents from all training regions responded with a response rate of 36%. A total of 28% reported having no access to a congenital cardiac unit in their training region, reflecting that 4 out of the 14 regions do not have a congenital unit. Although only 18% of trainees have undertaken a placement, a large proportion (74%) have considered a career in CCS, predominantly (50%) before entering training or in the first half of the training programme (38%). Reasons for not pursuing included discouragement by colleagues (42%) and concerns regarding the training pathway, citing, among other reasons, length of training, limited exposure to operations and uncertainty about career progression. Respondents suggested improvements to the training programme, including increasing exposure and early mentoring and steps to dispel unduly negative perceptions about the specialty. A large proportion of cardiothoracic trainees have a negative perception of CCS in terms of career and training. Interest wanes substantially after entry into the United Kingdom cardiothoracic training programme for several reasons. As well as short-term measures to improve exposure to CCS and structure of training, there has to be long-term planning to improve perception about this sub-specialty at all levels.

A matter of time: how musical training affects time perception.

Musical training has been linked to changes in early attentional and perceptual processing. Thus, such an altered attentional and perceptual processing has enabled musicians to judge the duration differently than non-musicians. Although these claims seem intriguing, there are many questions that are not addressed yet, for example, how would the performance of musically-trained differ from that of untrained on visual and auditory temporal judgments? Is there any advantage to musically-trained person in temporal processing? To understand these questions, we thus conducted a series of Auditory and Visual Temporal Bisection Tasks on 32 musically-trained and 32 musically-untrained participants. We hypothesized that if music training modulates general sensitivity to temporal dimensions, then the temporal judgments of musically-trained participants would differ from those of untrained participants in both visual and auditory tasks. Each participant performed a total of 140 trials (70 visual and 70 auditory) in two different blocks. For each participant, a Point of Subjective Equality (PSE) was obtained for visual and auditory conditions. The findings revealed a significant modality effect on time perception, with auditory stimuli being consistently overestimated compared to visual stimuli. Surprisingly, the musically-trained group exhibited a tendency to underestimate duration relative to the musically-untrained participants. Although these results may appear counterintuitive at first glance, a detailed analysis indicates that the length of musical training plays a significant role in modulating temporal processing within the musically-trained group.

Postresidency Practice Setting and Clinical Care Features According to 3 Versus 4 Years of Training in Family Medicine: A Length of Training Pilot Study.

Factors associated with physician practice choice include residency location, training experiences, and financial incentives. How length of training affects practice setting and clinical care features postgraduation is unknown. In this Length of Training Pilot (LoTP) study, we surveyed 366 graduates of 3-year (3YR) and 434 graduates of 4-year (4YR) programs 1 year after completion of training between 2013 and 2021. Variables assessed included reasons for practice setting choice, practice type, location, practice and community size, specialty mix, and clinical care delivery features (eg, integrated behavioral health, risk stratified care management). We compared different length of training models using χ2 or Fisher's exact tests for categorical variables and independent samples, and t test (unequal variances) for continuous variables. Response rates ranged from 50% to 88% for 3YR graduates and 68% to 95% for 4YR graduates. Scope of practice was a predominant reason for graduates choosing their eventual practice, and salary was a less likely reason for those completing 4 years versus 3 years of training (scope, 72% vs 55%, P=.001; salary, 15% vs 22%, P=.028). Community size, practice size, practice type, specialty mix, and practice in a federally designated underserved site did not differ between the two groups. We found no differences in patient-centered medical home features when comparing the practices of 3YR to 4YR graduates. Training length did not affect practice setting or practice features for graduates of LoTP programs. Future LoTP analyses will examine how length of training affects scope of practice and clinical preparedness, which may elucidate other elements associated with practice choice.

Addressing the Cosmetic Resident Education Gap – a Junior Cosmetic Fellowship Program

Abstract Goals/Purpose Incorporating adequate aesthetic surgery training into integrated plastic surgery programs in the United States has remained a challenge for several decades.[1-4] Specifically, residents report low confidence in performing facial cosmetic procedures compared to breast and body contouring.[1-2] This becomes increasingly relevant in the setting of heightened specialty creep and the rise in demand for cosmetic procedures overall according to the 2022 ASPS procedural statistics which show a 19% increase in cosmetic surgery procedures compared to the pre-pandemic 2019 report.[5] In a survey of 257 residents, 26.4% felt confident performing a lower blepharoplasty, 25% performing a facelift, 16.5% performing an endoscopic brow lift, and 14% performing a rhinoplasty.[2] This resident-reported difficulty with facial cosmetic procedures has shown little progress over time in reported survey data despite an increase in minimum cosmetic case numbers and length of training. A comprehensive aesthetic training also includes exposure to non-surgical interventions such as neuromodulators, injectables, non-surgical body contouring and facial rejuvenation technology. Though non-invasive fat reduction (ie. cryolypolysis) and non-surgical skin tightening (ie. radiofrequency micro-needling) have increased in demand since 2019 (77% and 22%, respectively), residents rarely have hands-on exposure to these treatment modalities.[5] Several integrated plastic surgery programs have a dedicated year of professional development or research, providing an opportunity for programs to fill this gap between cosmetic surgery training and real-world demand. Methods/Technique A junior cosmetic fellowship curriculum was created at a single institution focused on increasing confidence in performing aesthetic surgery, exposure to non-surgical cosmetic procedures, and increasing exposure to the business side of private practice. The fellowship was designed for a single resident during the professional development year of integrated plastic surgery training, completed between the third and fourth clinical years. The junior fellow spent the year within a single, multi-office private aesthetics practice in both the surgical and non-surgical setting. Over the course of the first four months (July 2023 - October 2023), the clinical experience of the Stanford junior cosmetic fellow was queried. Analysis of surgical case volume and non-surgical patient load was performed. This was then used to project surgical cases anticipated to be completed by year end. This was compared to case log minimums for graduating integrated plastic surgery residents in the United States, an essential metric of assessing resident experience and competence. Financial analysis of the non-surgical treatments by the junior fellow was performed. Using the initial four-month data, projections were also estimated to determine profitability for the practice over the course of the year-long fellowship. Results/Complications Over the span of the initial four months, the junior cosmetic fellow completed 69 cases, 58% of which were breast / body and 42% of which were focused on facial rejuvenation. It is estimated that at completion of the fellowship, this projects to 207 cases, exceeding the cosmetic ACGME program requirements for graduation. Total sales generated by the junior fellow during the first four months were as follows: $22,802, $90,257, $78,563, and $75,084 USD. Therefore, total sales by year end are estimated to be $800,118 in non-surgical treatments – demonstrating expertise of the junior fellow in non-surgical procedures and also profitability for the practice. Conclusion Increasing resident comfort with aesthetic surgical and non-surgical procedures is imperative as the demand for cosmetics continues to rise. Here we highlight the creation of a junior cosmetic fellowship, designed for programs with a year of professional development in their plastic surgery curriculum, to bridge the gap of cosmetic resident education. This junior fellowship model increases overall resident comfort in aesthetics and experience with facial procedures, a known weakness in resident training. Also, the addition of a junior fellow has shown to be financially lucrative for a practice, encouraging private practice attendings to consider this teaching model. Beyond the scope of programs with a dedicated year for professional development, this fellowship model may encourage embedded fellowships or incorporating mini-fellowships of 3-6 months in aesthetic surgery into residency programs outside of the traditional chief resident cosmetic experience.

Extending Context Window in Large Language Models with Segmented Base Adjustment for Rotary Position Embeddings

In the realm of large language models (LLMs), extending the context window for long text processing is crucial for enhancing performance. This paper introduces SBA-RoPE (Segmented Base Adjustment for Rotary Position Embeddings), a novel approach designed to efficiently extend the context window by segmentally adjusting the base of rotary position embeddings (RoPE). Unlike existing methods, such as Position Interpolation (PI), NTK, and YaRN, SBA-RoPE modifies the base of RoPE across different dimensions, optimizing the encoding of positional information for extended sequences. Through experiments on the Pythia model, we demonstrate the effectiveness of SBA-RoPE in extending context windows, particularly for texts exceeding the original training lengths. We fine-tuned the Pythia-2.8B model on the PG-19 dataset and conducted passkey retrieval and perplexity (PPL) experiments on the Proof-pile dataset to evaluate model performance. Results show that SBA-RoPE maintains or improves model performance when extending the context window, especially on longer text sequences. Compared to other methods, SBA-RoPE exhibits superior or comparable performance across various lengths and tasks, highlighting its potential as an effective technique for context window extension in LLMs.

The double-edged scalpel: Experiences and perceptions of pregnancy and parenthood during Canadian surgical residency training.

Only 34% of Canadian surgeons in 2022 were female. The protracted length of surgical residency training, concerns regarding infertility, and increased rates of obstetrical complications have been shown to contribute to the disproportionate lack of females in surgical specialties. A novel online survey was sent to all surgical residents in Canada. Respondents were asked about perceptions of pregnancy and parenthood during surgical training, and parents were asked about parental leave, accommodations they received, and pregnancy complications. Chi squared tests were used to compare opinions of male and female residents. A total of 272/2,419 (11.2%) responses were obtained, with a high response from females (61.8%) and orthopaedic residents (29.0%). There were 56 women reporting 76 pregnancy events during training, 62.5% of which had complications. Notably, 27.3% of men and 86.7% of women 'agreed' or 'strongly agreed' that surgeons have higher pregnancy complication rates than the general population (p<0.001). Men were much less likely to believe that pregnant residents should be offered modified duties (74.2% of men, 90.0% of women, p = 0.003). Women were much more likely to experience significant stigma or bias due to their status as a parent (43% of women, 0% of men, p<0.001). Women reported negative comments from others at a higher rate (58.5% of women, 40.7% of men, p = 0.013). Women believe there is negative stigma attached to being pregnant during training (62.7% of women, 42.7% of men, p = 0.01). The limitations of our study include a small sample size and response bias. Challenges and negative perceptions exist around pregnancy and parenthood in surgical residency, which disproportionately affect women trainees.

O102: Is there a gender disparity in the understanding and perceptions of orthopaedic surgery? Outcomes of The South West Orthopaedic Conference 2023

Abstract Aim This study aimed to evaluate the differences in understanding and perceptions of orthopaedic surgery between male and female delegates in a national student-led conference. Method This was a conference organised by students with the support of consultants from The Royal Devon and Exeter Hospital. The pre- and post-conference questionnaire had three sections comprising of understanding, motivations and barriers to pursing orthopaedic surgery. The results of this study analysed the pre-conference data differences between male and female delegates. Mann-Whitney test was used to determine differences in pre-conference responses according to gender. Results 62 delegates completed the questionnaire, of which 63% were male. There were no differences between genders on understanding of orthopaedics in the pre-conference questionnaire (p&amp;gt;0.05). Salary was more of a motivating factor in male delegates compared to female delegates (p&amp;lt;0.05). Lack of role models, number of years spent training and work-life balance were perceived as a barrier in more female compared to male delegates (p&amp;lt;0.05). There was no significant difference in lack of exposure during undergraduate training or negative experiences in orthopaedic placements in both genders. Conclusion The conference data highlighted that lack of role models, work-life balance and the length of orthopaedic training were more of a perceived barrier in females compared to males. We therefore encourage organisations such as Women In Surgery (WinS) and orthopaedic surgeons to encourage more female representatives in orthopaedics by providing provide support for student-led initiatives, to encourage the recruitment of women in orthopaedic surgery.

Staffing Patterns of Non-ACGME Fellowships with 4-Year Residency Programs: A National Survey.

Emergency medicine (EM) is one of few specialties with variable training lengths. Hiring a three-year graduate to continue fellowship training in a department that supports a four-year residency program can lead to conflicts around resident supervision. We sought to understand hiring and clinical supervision, or staffing, patterns of non-Accreditation Council for Graduate Medical Education (ACGME) fellowships hosted at institutions supporting four-year residency programs. We performed a web-based, cross-sectional survey of non-ACGME fellowship directors (FD) hosted at institutions supporting four-year EM residency programs. We calculated descriptive statistics. Our primary outcome was the proportion of programs with four-year EM residencies that hire non-ACGME fellows graduating from three-year EM residencies. Of 119 eligible FDs, 88 (74%) completed the survey. Seventy FDs (80%) indicated that they hire graduates of three-year residencies. Fifty-six (80%) indicated that three-year graduates supervise residents. Most FDs (74%) indicated no additional requirements exist to supervise residents outside of being hired as faculty. The FDs cited department policy, concerns about quality and length of training, and resident complaints as reasons for not hiring three-year graduates. A majority (10/18, 56%) noted that not hiring fellows from three-year programs negatively impacts recruitment and gives them access to a smaller applicant pool. Most non-ACGME fellowships at institutions with four-year EM programs recruit three-year graduates and allow them to supervise residents. This survey provides programs information on how comparable fellowships recruit and staff their departments, which may inform policies that fit the needs of their learners, the fellowship, and the department.

Effects of training length on adaptation to noise-vocoded speech.

Listeners show rapid perceptual learning of acoustically degraded speech, though the amount of exposure required to maximize speech adaptation is unspecified. The current work used a single-session design to examine the length of auditory training on perceptual learning for normal hearing listeners exposed to eight-channel noise-vocoded speech. Participants completed short, medium, or long training using a two-alternative forced choice sentence identification task with feedback. To assess learning and generalization, a 40-trial pre-test and post-test transcription task was administered using trained and novel sentences. Training results showed all groups performed near ceiling with no reliable differences. For test data, we evaluated changes in transcription accuracy using separate linear mixed models for trained or novel sentences. In both models, we observed a significant improvement in transcription at post-test relative to pre-test. Critically, the three training groups did not differ in the magnitude of improvement following training. Subsequent Bayes factors analysis evaluating the test by group interaction provided strong evidence in support of the null hypothesis. For these stimuli and procedure, results suggest increased training does not necessarily maximize learning outcomes; both passive and trained experience likely supported adaptation. Findings may contribute to rehabilitation recommendations for listeners adapting to degraded speech signals.

Tracing the disc: The novel qualitative morphometric MRI based disc degeneration classification system.

This study aimed to develop a classification system for lumbar disc degeneration using routine magnetic resonance images (MRIs) that is easily applicable and unaffected by existing classifications' limitations, and to compare its reliability, reproducibility, and discriminative power to the widely used Pfirrmann classification. Five features were graded. This new classification system has eight grades, with at least one of these five features altering each grade. The T2-weighted sagittal images were acquired using a rapid spin-echo sequence with a repetition time of 2680 to 4900 milliseconds, an echo time of 100 to 109 milliseconds, and an echo train length of 17. Slice thick was 4 mm and the display field of view was 32 × 32 cm. The new classification system used five features: signal intensity, disc height, disc boundary regularity, and nucleus annulus separation. Increased signal intensity, decreased height, decreased regularity, and decreased nucleus-annulus separation indicated degeneration. Four raters classified 400 discs from 80 patients using the Pfirrmann and Novel systems. Statistical analyses were conducted to investigate reliability and correlation. The overall ICC and kappa values were found to be higher in the novel classification. (0.988 indicating excellent agreement for ICC and 0.76/0.94 indicating good-very good agreement for kappa). The Kendall tau c value, which shows the correlation between the two classifications and indicates the validity of the new classification, was 0.872, which is very strong. Through the use of cross-tabulations, the discriminatory power of the two newly added classification criteria was determined. This study demonstrates the intra-rater and inter-rater reliability of an easy-to-use, discriminative novel morphometric MRI based classification system for lumbar disc degeneration. The differentiation of grades based on five distinct criteria may generate novel hypotheses regarding treatment selection and response monitoring, as well as new insights into the study of disc degeneration.

Addressing Infertility and Other Reproductive Outcomes Among Female Physicians

Infertility affects one in four female physicians in the United States, yet the topic of fertility among female physicians is understudied and warrants focused strategies to implement change. Factors that exacerbate the rates of infertility in female physicians include intentional delays in family planning that are driven by the length of medical training and career advancements, age, long working hours, and physician burnout. While the effects of COVID-19 on reproductive health remain uncertain, the virus may have played a role in illuminating an already existing issue in women’s reproductive health. Burnout rates among female physicians have reached record highs contributing to reproductive disorders that warrant well-deserved attention to this issue. Initiatives should focus on fertility education in undergraduate medical education, organizational-level interventions, better insurance coverage for infertility treatments, and addressing burnout. Collaborative efforts between individuals, institutions and organizations are needed to prioritize reproductive health among female physicians.

Addressing Barriers to Entry and Retention of Women in Interventional Vascular Specialties With Proposed Solutions: A Scientific Statement From the American Heart Association.

Representation of women in interventional vascular fields (interventional cardiology, interventional radiology, and vascular surgery) lags behind that in other specialties. With women representing half of all medical school graduates, encouraging parity of women in these fields needs to start in medical school. Barriers to pursuing careers in vascular intervention include insufficient exposure during core clerkships, early mentorship, visibility of women in the field, length of training, lifestyle considerations, work culture and environment, and concerns about radiation exposure. This scientific statement highlights potential solutions for both the real and perceived barriers that women may face in pursuing careers in vascular intervention, including streamlining of training (as both interventional radiology and vascular surgery have done with a resultant increase in percentage of women trainees), standardization of institutional promotion of women in leadership, and professional and industry partnerships for the retention and advancement of women.

Comparing the impact of different adsorbed layers on the local glass transition of polymer matrices.

Chain adsorption to nanofiller interfaces creating bound layers has become central to understanding property changes in polymer nanocomposites. We determine the impact different kinds of adsorbed layers can have on the local glass transition temperature Tg of polymer matrices in a model film system using a localized fluorescence method. This work compares the adsorption and desorption of adsorbed layers grown in solution with the solution washing characteristics of adsorbed layers formed in the melt, leveraging knowledge about polymer adsorption in solution to infer the structure of adsorbed layers formed in the melt. In the limit of zero concentration after a long time in solution, we find that both kinds of adsorbed layers reach the same limiting adsorbed amount h∞(c → 0) ≈ 1 nm, appearing to evolve to the same thermodynamic equilibrium state of a near monolayer of surface coverage. We propose that melt annealing leads to a coarsening of polymer segment-surface contacts, increasing the length of trains and shrinking loops and tails, slowing the subsequent kinetics of these adsorbed chains in solution. Considering how the pyrene-labeled chains intermix with the adsorbed layer enables us to discriminate between the impact of tails, loops, and trains as threading of loops takes longer. We find that large fluffy loops, tails, and trains have little to no impact on the local Tg. A large 30K increase in local Tg is observed for 30-minsolvent washed well-annealed films at long intermixing times that we attribute to the threading of small tight loops.

The effect of cognitive training on children with attention deficit and hyperactivity disorder: A meta-analysis

Objective This document is a meta-analysis of randomized controlled trials that evaluated the effect of cognitive training interventions on attention deficit and hyperactivity disorder (ADHD) symptoms. Methods A systematic literature search was conducted using databases such as PubMed, Web of Science, and Embase from the inception of each database to April 28, 2022. Data were analyzed using Stata 15 software. The risk of bias assessment was conducted using five domains from the Cochrane Collaborations tool. Results A total of 10 studies with 446 children with ADHD were included. The results showed that cognitive training was effective in improving attention symptoms [SMD= −0.78 (95% CI: −1.46, −0.1)] and executive function [SMD = −0.3 (95% CI: −0.56, −0.05)] in children with ADHD compared to controls. No significant difference in the degree of improvement in hyperactivity/impulsivity with cognitive training compared to the control group [SMD = −0.65 (95% CI: −1.35, 0.05)]. In addition, subgroup analyses also found that cognitive training significantly improved attention in children with ADHD <10 years of age [SMD = −1.3 (95% CI: −2.58, −0.02)] and children with ADHD with length of training >30 days [SMD = −0.94 (95% CI: −1.81, −0.07)] compared to controls. Conclusion This meta-analysis found that the beneficial effects of cognitive training on attention (particularly for children with ADHD <10 years old and >30 days of training) and executive function in children with ADHD, but not on hyperactivity/impulsivity.

Analysing the Relationship between Gluteus Maximus Muscle Activity and Hamstring Muscle Length and its Influence on Sit to Stand Activity in Persons with Sacroiliac Joint Dysfunction

Background: The sacroiliac (SI) joint has been found to be a source of discomfort for 25 to 35% of people sufferingfrom persistent low back pain. Though the Gluteus Maximus and Hamstring muscles play a vital role in sit-tostandactivity in normal people, its role in individuals with sacroiliac joint dysfunction is yet to be studied.Purpose: To assess the association between Gluteus Maximus activity and Hamstring muscle length and determinethe efficacy of Gluteus Maximus activation exercise and Hamstring muscle eccentric training on improving sit-tostandactivity in people with SI Joint dysfunction.Materials and Methods: In the first phase of the study, Hamstring muscle length, Gluteus maximus muscleactivity, Pain during sit-to-stand activity was recorded. All thirty participants in the second phase of the studyunderwent six weeks of Hamstring muscle eccentric exercise and Gluteus Maximus muscle activation exercise.Results: A Pearson correlation test shows a positive correlation (r = 0.208) but the weaker relationship between thevariables. Paired t test analysis shows a significant improvement after the treatment in terms of Gluteus Maximusmuscle activity, Hamstring muscle length and pain reduction with a P value &lt; 0.001.Conclusion: This study concluded that Gluteus Maximus activation exercise and Hamstring muscle eccentrictraining will significantly improve sit to stand activity and reduce pain.

Information and approaches of emergency department physicians in the Cappadocia region regarding the preparation of forensic reports

Aims: Forensic reports; these are physician’s opinion and opinion reports, which are mostly prepared by emergency room physicians regarding the medical conditions of people and reported to the judicial authorities. In this study; it was aimed to examine the attitudes and behaviors of emergency physicians working in the Cappadocia region regarding the preparation of forensic reports. Methods: This cross-sectional study; it was conducted with a survey applied to 73 emergency physicians working in Nevşehir city center and districts. The data was created based on the answers given to this survey form. Results: The majority of physicians participating in the study are general practitioners (87.7%). The average length of service of the participants is 2.3 1.1 years. Most physicians reported that the forensic medicine training they received was insufficient (75.3%). Survey answers of the participants; They were compared in terms of their titles, length of service and forensic medicine training. Conclusion: Regular in-service training should be provided at intervals so that more appropriate forensic reports can be kept and physicians can have more information about the legal part of forensic reports.

Resident Involvement in Curricular and Clinical Practice Change and Satisfaction With Training According to Length of Training in Family Medicine.

Most research in residency training has focused on quality improvement within a single program. We explored resident involvement in curricular and clinical practice change, the learning environment, and resident satisfaction in 3-year family medicine residencies compared to matched 4-year residencies. We used two surveys to capture data. One was for program directors, which assessed the level of resident involvement in curricular and practice transformation. The second was a resident survey, which asked residents to rate their involvement in curricular change and practice transformation, the learning environment, and satisfaction with training. Both were administered annually between 2013 and 2019. Response rates ranged from 84.6% to 100%. Findings revealed no overall difference in resident involvement in curricular change, but the program director survey findings indicated that a higher proportion of residents in 4-year programs were using a broader diversity of approaches to working on quality improvement (QI) projects compared to those in 3-year programs. We also found statistical differences in the number of QI projects completed per year, with 34.1% completing three or more in 4-year programs compared to 13.3% in 3-year programs (P&lt;.001). We found a positive correlation between resident involvement, learning environment, and satisfaction with training for both 3-year (range 0.489-0.666; P=.001) and 4-year residents (range 0.441-0.529; P=.001). Four-year residents were involved in a greater number of quality improvement projects and had a more diverse profile of involvement than those in 3-year residency programs. Involvement in practice and curricular change and the learning environment were associated with greater levels of resident satisfaction with training in both 3-year and 4-year programs.

Neighbor-based joint spatial division and multiplexing in massive MIMO: user scheduling and dynamic beam allocation

AbstractTwo-stage precoding schemes have been developed to reduce the channel estimation overhead in FDD systems. By integrating user scheduling into these schemes, it becomes possible to meet the quality-of-service requirements of high-density wireless communication systems, despite the limitations on spatial resources and transmit power budget. In this paper, we propose a user scheduling and dynamic beam allocation method for neighbor-based joint spatial division multiplexing (N-JSDM) transmission. The user scheduling problem is formulated as a 0–1 quadratic programming problem to maximize effective spectral efficiency (ESE) using directional channel properties. To address the complexity issue, convex relaxation and linearization methods are employed to transform the problem into a 0–1 mixed integer linear programming, and a dimensionality reduction method is introduced. The proposed user scheduling-aided N-JSDM scheme reduces downlink training length and feedback of channel state information. Additionally, a dynamic configuration form is used for pre-beamforming matrix design based on user distribution, outperforming conventional approaches. Simulation results demonstrate higher ESE achieved by the proposed scheme compared to previous methods.

Pediatric Surgery Workforce Around the World: A Need to Revise Residency Programs?

Objectives:The study aimed to address the shortage of pediatric surgery specialists globally by investigating the discrepancies in training programs and population metrics across different countries and regions. Methods: An international survey of pediatric surgeons gathered data on training duration, examination procedures, certification, and population metrics like mortality rate and surgeon-to-population ratio. Results: The study included 44 countries. The average length of pediatric surgery training was 5.7 years, with no significant difference between different regions. The pediatric mortality rate and surgeons count per 100 000 people were inversely correlated, while training duration was associated with GDP and life expectancy, but not pediatric mortality rate or surgeons' count. Conclusion: Many countries' pediatric surgery training programs do not align with their actual need for pediatric surgeons. Nations with limited economic resources may opt to shorten residency programs or offer pediatric surgery as a direct specialty after medical school to mitigate the shortage effectively.

Low back pain in medical workers and its influencing factors.

To investigate the prevalence of occupational lower back pain (OLBP) among medical workers and identify the contributing factors. An electronic questionnaire was distributed to medical workers at Yuebei People's Hospital to gather information on various factors, including gender, age, body mass index (BMI), length of employment, job role, education level, professional title, marital status, fertility status, frequency of night shift, weight lifting daily, duration of daily standing at work, frequency of bending, work-related stress, experience with low back protection training, and frequency of waist exercises. Univariate and multivariate logistic regression analyses were conducted to identify the factors associated with OLBP in medical workers. Out of the 98 medical workers surveyed, 67 experienced OLBP (68.37%). The results of multivariate logistic regression analysis revealed that working for more than 5 years, holding a nursing position, and lacking training in low back protection were significant risk factors for developing OLBP in medical workers (all P<0.05). OLBP is a prevalent issue among medical workers, and various factors such as length of employment, job role, and training in low back protection can influence its occurrence.